Nomogram based on the pre-treatment systemic oxidative stress score to predict the prognosis of surgically treated patients with oral squamous cell carcinoma: competing risk model analysis.

The aim of this study was to explore the prognostic predictive importance of the pre-treatment systemic oxidative stress score (SOS) in surgically treated patients with oral squamous cell carcinoma (OSCC). A prospective cohort study was conducted involving 591 patients who underwent surgical treatment for OSCC between May 2011 and March 2022. The SOS was derived from a composite integration of clinically relevant oxidative stress biomarkers: total bilirubin, blood urea nitrogen, creatinine, lactate dehydrogenase, and serum albumin. A variety of analytical methods, including competing risk models, generalized boosted regression modelling (GBM), and propensity score matching analysis, were employed to evaluate the prognostic significance of the SOS. Multivariable Fine-Gray analysis revealed that patients with a high pre-treatment SOS exhibited significantly worse disease-specific survival (DSS) than those with a low SOS (original cohort: hazard ratio 3.58, 95% confidence interval 2.19-5.85, P < 0.001; matched cohort: hazard ratio 3.60, 95% confidence interval 2.10-6.43, P < 0.001). GBM revealed that the relative influence of SOS ranked third. Elevated SOS was confirmed as an independent factor for poor DSS in patients with OSCC. This index may be used to facilitate personalized treatment strategies and optimized postoperative follow-up.